The Five Methods of Acupuncture
In Chapter 25 of Chinese medicine’s oldest surviving text, The Yellow Emperor’s Canon of Internal Medicine, the famous Yellow Emperor asks the wise Qibo to tell him about acupuncture methods. He requests of Qibo: “What I intend is to alleviate the pain of the patients…can you tell me what method of acupuncture should be applied?”  Qibo then describes five acupuncture methods.
Before describing the five methods, he expresses to the Yellow Emperor that most people only care about “their meal only,” perhaps implying that they do not take the time to really understand all the ingredients that make up the meal. He says that these five methods are available for everyone to utilize but most people do not take the time to understand them. This is a fitting metaphor for modern day approach, of the majority, to the study of the The Yellow Emperor’s Canon of Internal Medicine. In many cases, people do not approach it at all; perhaps because they think it is too tedious to read, too vague to be applied practically, and in some cases, too difficult to interpret a direct meaning. When Qibo comments that most people only care about “their meal,” or what is directly in front of them, it can be likened to the metaphor of most people taking “the path of least resistance.” Trying to interpret the Nei Jing in the 21st century is like taking the road less traveled, or seeking out a hidden road, without a clear roadmap. The response that Qibo gives is simple yet extremely profound, especially when applied to the Nei Jing’s place in TCM. TCM does not place much, if any emphasis on studying the wisdom in this classic, for precisely the reasons I describe above.
Qibo continues his discourse by offering a description of each of the five methods of acupuncture. The first method he offers is to: “Concentrate the attention.” He elaborates on this principle by expressing that the correct method of “pricking” can only be determined after all relevant data has been ascertained. The practitioner must be able to concentrate full attention when determining if the patient’s viscera is presenting sthenia (excessive vital force), or asthenia (weakness) & the quality of the “nine sub-parts of the pulse.” He explains that the concentration must become refined enough to allow the practitioner to drown out distractions such as noise, or other people who might be observing the treatment. Qibo also emphasizes that the practitioner should never rely on outer observations of the patient only, but must focus on pulse examination.
Qibo says that it is imperative to have a mature sense of the patient’s ailment. Additionally, he comments on the importance of being able to develop a sense of the channel energy and how it moves, describing this perception as being important in determining the appropriate time to needle. When the channel energy is in the right place, the practitioner must not delay the opportunity to needle, but be diligent in applying theneedle appropriately. He says, “Pricking is easy in purging but difficult in invigorating.” If someone is suffering from an asthenic disease, it is better to needle gently, but if someone is suffering from a sthenic ailment, it is appropriate to needle without hesitation. Once the needle has been applied, it is important for the practitioner to concentrate when twisting the needle; it will ensure that “the pricking is clean and smooth.” Concentration will expand a practitioner’s ability to sense any movement or changes in the channel energy. Qibo also says, “One must pay attention to the breathing of the patient and examine the expected energy change.” His extensive elaboration on the first acupuncture method is appropriate given that concentration is a skill that does not come effortlessly; it can be intense and require a lot of work to develop. “When twisting the needle, one must be very careful as if he is standing on the edge of an abyss, and be very concentrative as if holding a fierce tiger. In a word, one should concentrate his (her) mind, and not be disturbed by other things.” Concentration can be difficult to master because there are so many things to get distracted by, yet it is only through concentration and focus that the practitioner can develop the subtly of perception needed in order to observe the movement of channel energy. While it may not be necessary for everyone to master the art of concentration, it seems like a basic tenet in delivering an optimal treatment.
The second acupuncture method he presents, refers to taking “care of the body.” While it is not clear to me if Qibo is speaking of the practitioner or patient’s body, I prefer to interpret it as both. The body is the where all the organ officials live and should be cared for in such a way as to honor the material/non-material beings that inhabit it.
The third principle addressed is: “Knowing the actual property of the medicine.” My understanding of this statement boils down to the practitioner’s attainment and study of a solid repertoire of knowledge of the properties of herbs and acupuncture points, channels, and the importance of having a firm grasp of the underlying theories surrounding their use.
The fourth property is stated as “preparing different sizes of stone needles to meet the need of treating various diseases.” The fourth method is fairly self-explanatory in that a practitioner must be prepared for the treatment of different conditions by having a variety of needles available to work with. In other words, “No one needle size fits all.”
In his fifth and final statement about acupuncture methods, Qibo describes: “Knowing the diagnostic method for the viscera, blood, and energy.” This statement refersto the aforementioned importance of knowing the appropriate methods for determining and diagnosing the states of the patient’s viscera and pulses.
Qibo explains that all the methods have their strengths. It falls to discretion of the practitioner as to which situations he/she wishes to apply the five methods of acupuncture in. He emphasizes that there is nothing “mysterious” about these methods, and if a practitioner simply applies the yin yang laws of nature, then he/she will achieve unique clinical results.
 Wu Liansheng and Wu Qi, Yellow Emperors Canon of Internal Medicine (Beijing: China Science and Technology Press, 1997) 143.
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